title: Role of surgery in limited (T1-2, N0-1) cancers of the oropharynx.
abstract: OBJECTIVE
  To define the role of surgical staging in limited (T1-2, N0-1) oropharyngeal squamous cell cancers.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Forty-nine limited oropharyngeal squamous cell cancers of the tonsil, tongue base, or posterior pharyngeal wall-treated surgically were identified.
  
  
  RESULTS
  Thirty-five percent were cT1 and 65% were cT2 tumors although 58% were cN0 and 42% were cN1. Forty-six patients underwent neck dissections. Surgical staging altered T-stage in 26% (13/49), nodal status in 23% (11/46), and clinical staging in 40% (20/49) of patients. Among 35 disease-free patients, 28% (4/20) of stage I/II patients received postoperative radiation and chemotherapy was avoided in 80% (12/15) of stage III patients. T1 tumors seemed to have better outcomes (P = .06). The 3 year disease-free survival and 5 year overall survival was 85% and 83%, respectively.
  
  
  CONCLUSIONS
  Surgical staging identifies patients in whom intensification of treatment with chemotherapy can be most appropriately applied, and enables de-intensification of therapy in pathology confirmed stage I/II disease.
authors.affiliation: Department of Otolaryngology, Head Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Rohan R
authors.initials: RR
authors.lastname: Walvekar
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Li
authors.forename: William E
authors.initials: WE
authors.lastname: Gooding
authors.forename: Michael K
authors.initials: MK
authors.lastname: Gibson
authors.forename: Dwight
authors.initials: D
authors.lastname: Heron
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D018714:Radiotherapy, Adjuvant